CDC says U.S. gatherings of over 50 people should be put off | Hacker News Reader

CDC says U.S. gatherings of over 50 people should be put off

bloomberg.com

311 pointsinfodocket375 comments

> The advisory doesn’t apply to the day-to-day operation of organizations such as schools, institutes of higher learning, or businesses...

Why not? A theater playing Emma on a schedule isn't somehow safer than a movie theater hosting a one-time corporate event, for the same number of people. Or a normal day at a large restaurant versus the same restaurant reserved for a private party. Why advise that the later be put off but not the former?

> Events of any size should only be continued if they can be carried out with adherence to guidelines for protecting vulnerable populations, hand hygiene, and social distancing

Say such a business tried to continue to hold events while adhering to the guidelines. It seems that "protecting vulnerable populations" would mean not admitting people with comorbidities, such as the elderly, obese, diabetic, smokers, etc. I'd think that equal access laws such as the ADA would prevent such an attempt.

At first I was happy to see this. But now I am not happy to see this, because it's making me realize that this is the only action that's going to be put in place over the next few days.

Too little, too late. This type of regulation made sense 2 weeks ago, combined with a halting of all international travel and an advisory against interstate travel.

The virus got out of control though. We don't know how many are infected, but we know our ground zero is 10-100x worse than the ground zero of nations that managed to get things under control.

People need to brace for impact. The US medical system is going to be overwhelmed by people in critical condition. The government has been too slow to respond.

Yes, it's late. But it's still better to do than not.

> People need to brace for impact. The US medical system is going to be overwhelmed by people in critical condition.

I'd just like to point out that when you say the "US medical system" you're talking about a large area. It's not like a country like Italy which is smaller than the state of California but 30% more people. The US is far more spread apart and while that doesn't mean it will be better here, it does mean that you can't think about the US just like a single country. Same with China, too.

You’re still only talking about 700,000 beds for a disease that will likely cause 1,000,000 deaths and put huge numbers in the ICU and even more in hospital care.

A bed in Maine does no good if the patient is in LA and the doctor is in North Dakota.

Let's also not forget the trend for years has been to eliminate beds to save $$$. Rural hospitals will be hit the worst by this, most are now just outpatient hospitals with limited number of beds.

I think as the number of cases explode with more testing availability, governments at all levels will be pressured into taking more action if only to show the population something is being done.

But yes, we now know it's already too late. The US has failed to contain the disease like China, Hong Kong, Taiwan etc did, and the CDC already expects most of the U.S. population will be exposed to this virus eventually. There's no precedent yet for a COVID-19 epidemic of this size -- China has successfully contained it, and Italy's population is just 1/5 of the US.

But on the other hand, we as average people can still do our part and meaningfully contribute to flattening the curve. Even one unnecessary death avoided is a win.

Meetings over 1 should be avoided.

Wash hands. Cover coughs. Maintain a minimum of 6ft distance .

The effectiveness of this warning on people who would not already limit their gatherings is questionable. Many people are just in denial or deluded about how serious this pandemic is, and are unlikely to significantly change their behavior until and unless people start dropping dead all around them.

The most effective thing the CDC can do is just to dramatically increase the amount of testing by hundreds or thousands of times over what it's doing now, then publish the results. If people know how many others are infected all around them it might give more of them pause.

The government also needs to do whatever it takes to increase ICU capacity at hospitals, and give them more resources and support of every kind.

We are very likely on the brink of a collapse of the ability of our health care system to take care of the most vulnerable, with a death toll that will dwarf in American casualties any war the US has been in and the direst of economic consequences if the pandemic is not slowed to a manageable level.

> We are very likely on the brink of a collapse of the ability of our health care system to take care of the most vulnerable, with a death toll that will dwarf in American casualties any war the US has been in and the direst of economic consequences if the pandemic is not slowed to a manageable level.

This seems over the top.

I thought the death rates are insignificant for those younger than 60, and those who succumb to it already have pre-existing health/respiratory issues. Doesn't influenza cause thousands of deaths per year?

I am mostly playing devil's advocate, I am genuinely curious to hear why you have so much fear.

Even the best-case estimates right now have US deaths at 2 million. i.e. 70% of people infected (230mil), 1% of those people die (2.3mil).

1% death rate is extremely low, it will more likely be 3 or 4 or 5.

It's very possible 10 million people in the US are going to die (5% of infected).

This is blatantly untrue. Worst case scenario is currently believed to be 1.7 million deaths.

https://thehill.com/homenews/sunday-talk-shows/487652-fauci-...

That only holds if all of the people suffering severe cases can get enough medical care, which becomes much less likely if hospitals get overwhelmed. That's why 'flattening the curve' is extremely important.

What are you basing that statement on? The worst case-scenario is based on a scenario where no effort is made to protect against the spread of Coronavirus and I'd imagine the CDC considered the impact of overwhelmed hospitals when doing their analysis.

From a Penn State epidemiologist (note that the quote below speaks of the "infection fatality rate", which is different from the "case fatality rate", the difference is explained in the article)[1]:

"Scientists working at the London School of Hygiene and Tropical Medicine, Imperial College London and the Institute for Disease Modeling have used these approaches to estimate the infection fatality rate. Currently, these estimates range from 0.5% to 0.94% indicating that COVID-19 is about 10 to 20 times as deadly as seasonal influenza. Evidence coming in from genomics and large-scale testing of fevers is consistent with these conclusions. The only potentially good news is that the epidemic in Korea may ultimately show a lower CFR than the epidemic in China.

...

"On balance, it is reasonable to guess that COVID-19 will infect as many Americans over the next year as influenza does in a typical winter -- somewhere between 25 million and 115 million. Maybe a bit more if the virus turns out to be more contagious than we thought. Maybe a bit less if we put restrictions in place that minimize our travel and our social and professional contacts.

"The bad news is, of course, that these infection numbers translate to 350,000 to 660,000 people dying in the U.S., with an uncertainty range that goes from 50,000 deaths to 5 million deaths. The good news is that this is not a weather forecast. The size of the epidemic, i.e., the total number of infections, is something we can reduce if we decrease our contact patterns and improve our hygiene. If the total number of infections decreases, the total number of deaths will also decrease."

This analysis is a little old, however (from March 9th, six days ago), and assumes that the rate of infection of COVID-19 is comparable to seasonal influenza. A recent This Week in Virology podcast[2] had another epidemiologist, Ralph Baric, of the University of North Carolina Chapel Hill, who had this to say:

"The R0, or the number of people who become infected from an infected individual, is estimated somewhere between 2.5 and 3.2. That's actually quite high. That means that for every case there is two and a half to three additional cases. Contemporary flu is much closer to 2 or 1.8, 1.6. So this is very explosive spread and rapid transmission. It's even more explosive because you have rare individuals or maybe not so rare individuals who are superspreaders, who can infect 15, 20 people just passing through a room."[3]

"In Canada there was one example of a superspreader who simply walked through an emergency room that was packed that was fairly packed with individuals and infected 19 people in the less than the 15 seconds they were in the emergency room as they walked through it."[4]

With such explosive growth, the health care systems stands a very good chance of being overwhelmed, causing substantially more deaths. For instance, those 10% to 17% of severe cases that might have otherwise survived had they gotten care in an ICU could well die because they can't get that care. In addition many other, non-infected people who need critical care may not be able to get that care either and die, raising the overall death toll even higher.

[1] - https://www.marketwatch.com/story/why-this-epidemiologist-is...

[2] - http://www.microbe.tv/twiv/twiv-591/

[3] - about 8 minutes in to the program

[4] - about 38 minutes in to the program

Are you suggesting that the CDC didn't consider the impact to the healthcare system when doing their epidemiological projections? I think you are severely underestimating the CDC's competence.

This CDC article [1] Estimates worst case at 1.7 million deaths. Let's dig into that.

They say it could be up to 214 million infected ( which is 64.8% of the population, so my number differs from theirs by 5.2%), but they say only 1.7 million deaths. That's a CDC projected death rate of 0.8% .... which is extremely optimistic.

The WHO says 3.4% [2]

China 3.6% - 6.1% [2]

Italy 3-4% [2]

So I have no idea why the CDC would make their estimates based on a 0.8% death rate. That doesn't seem realistic to me, especially when we know the US has less hospital beds per capita than for example Italy.

[1] https://nymag.com/intelligencer/2020/03/cdcs-worst-case-coro...

[2] https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...

So first off I've spent enough time with people in epidemiology/at the CDC to know that I (and probably you) don't know enough to have a more accurate armchair analysis than what their experts produce. Second, I would imagine ICU/critical care beds per capita is a better predictor of fatality rate than hospital beds and the US is very well equipped in that regard. The US medical system has numerous flaws, but in terms of technical ability to keep extremely sick people alive, the US is pretty good. We can debate the details, but since neither of us are experts it's probably a waste of time.

However, there is absolutely no basis to say "best-case estimates right now have US deaths at 2 million". It is blatantly untrue - it directly contradicts every single expert analysis that I have seen.

The us has more icu beds than italy.

Percapita?

Obviously there are more American ICU beds in absolute numbers, but also there is a bigger population.

Because in South Korea the rate is more like 0.5% and they've done the most testing.

As far as I can tell, basically all the data around this epidemic is so dubious it's nearly useless. We use it anyway because ignoring data is really hard when the alternative is intellectual darkness. Yes, that's a strong claim, but look at the error bars! Above in this thread we have someone giving two estimates for total dead in the USA that vary by a whole order of magnitude.

A difficulty with all current rates is that nobody knows the denominator: how many cases are there really? Some cases are asymptomatic, many are mild, people got the message by now to stay home and try to avoid overloading the health system so they aren't necessarily going to turn up to get tested unless they start to feel really quite bad. To know this you'd need mass random testing of the population, but nobody is doing that, not even in South Korea.

If you divide deaths by cases that turned up at hospital you get these higher rates. But that can't then be multiplied by population figures to derive total expected death rates. It's more like a "death rate of those who make themselves known because they have severe symptoms".

Another problem with these stats is people tend to interpret them as "number of people who will die who otherwise wouldn't have", i.e. imagining a drop in the population graph. But many of those who are dying were about to die of old age or other factors, so deviation from standard death rate isn't going to be that high. The causes of death will shift, but the total number will be less than a simple "Chinese rate * population" calculation.

The deaths aren't going to be limited to those that get infected either. As the health care system gets overwhelmed many others in critical need of lifesaving care will be unable to get it.

That's not to mention the shortages of medicines and medical equipment made in China and other vulnerable places around the world that the US relies on.

For example, 97.1% of fatalities in Italy are over 60 years old, and 99.9% of fatalities are over 50 years old.

The 65+ crowd isn’t living paycheck to paycheck and working every day to pay for rent and groceries. There are a lot of people living paycheck to paycheck who are at basically zero risk from this virus who should be allowed to work.

Since we’re talking about a few trillion dollars of economic damages, I would expect something a bit less hysterical and a bit more focused on the actual at-risk population.

I think that you're missing the point that younger people are still at risk of infection. They're far less likely to die, and so make great carriers.

I’m not missing that fact at all. People who are at risk should self-isolate, and we should put policies in place to assist the vulnerable population in doing so.

The most at risk population is also very unlikely to depend on a weekly paycheck.

You're conveniently avoiding engaging with the part where "let people just go to work" means that the death rate in under-60 severe cases skyrockets because hospitals can't handle that many people needing ventilators and round-the-clock care all at once.

People with mild symptoms aren’t going to the ICU at all. And overall disease severity even in hospital cases is significantly lower in people < 50yrs .

> a lot of people ... at basically zero risk from this virus

This is a super dangerous myth. Death is not the only risk. Here’s what this coronavirus does to the body:

https://www.nationalgeographic.com/science/2020/02/here-is-w...

TL;DR: It’s nasty, can leave lasting damage.

"Let the young people go to work" means you now have to somehow completely isolate everyone over 60... while still providing them health care from uninfected people... while almost literally everyone else in the country is getting infected.

And even then, 3% fatalities under 60 with a 2% fatality rate means that 0.06% of those people under 60 will die. In the US, that means a minimum of (napkin math: 327 million * 85% * 0.06%) 1.66 million people, and almost certainly much more than that, because all of those under-60 severe cases are wildly overloading hospitals and so are unable to get the care they need.

All of this is the strategy that the UK is currently undertaking, which can be generously described as "completely insane" because they don't have the support system for all of those over-60 people to safely self-isolate or the hospital capacity to handle the flood of severe under-60 cases that will show up over the next month or so.

It seems like the alternative is to completely isolate everyone so I’m not sure why isolating just the at-risk population is worse than that.

We have ~100 cases in MA currently. On April 20th when we have ~100 do we have to lock down the state all over again?

The alternative is to implement incredibly thorough public safety measures like those currently in place in China and Korea, where mass screening, comprehensive and constant public sanitization programs, strict controls on travel and public events, and mass emplacement of new temporary hospitals are in place. Both countries are doing extremely well in controlling the spread of the virus on a per capita basis, and doing well enough that they will probably soon be able to lift those measures piece by piece as long as they also keep tight control of external travel.

This means actually spending money on public health infrastructure, though, so it seems unlikely to happen in the US.

Economic hardship does not kill those under 35. You need to focus on the social good.

Think your decimal is off. 327 million * 85% * 0.06% is 166 thousand, not 1.66 million.

Projections range from 200,000 dead to 2.x million dead in the US alone.

I don't care what age or what pre-existing conditions those people have... that is a LOT of human death and suffering.

...not to mention the millions of survivors that will require being hooked up to a mechanical ventilator and walk away with permanent lung damage.

I thought it was 1 million dead absolutely best case scenario, and 11 million dead worst case.

> The effectiveness of this warning on people who would not already limit their gatherings is questionable. Many people are just in denial or deluded about how serious this pandemic is, and are unlikely to significantly change their behavior until and unless people start dropping dead all around them.

I disagree. People are definitely in denial, and seeing people die around them will "help" in getting them over that denial.

But it's not the only way. The government encouraging or enforcing a quarantine, for example, is also going to get people to take this seriously.

E.g. over here in Israel, we've seen cases go up a bunch but deaths are luckily still not that high. However, while people here still aren't taking this seriously enough IMO, the fact that the government has effectively shut down all restaurants, all educational establishments, etc., is definitely helping to get through to people that this isn't business as usual.

This will become the new normal. A two week quarantine won't fix anything, and the virus will spread all over again once the quarantine is lifted and a bunch of not immune carries venture out in public again. Then we will go into another lockdown and the cycle will repeat.

They won’t lift the lockdown until we’ve hit certain markers, I’m sure.

This is why de Blasio took so long (or rather was forced by Cuomo and other state’s moves) to close schools. Once you close the schools, they aren’t opening for the rest of the year and potentially into the next school year.

Bingo. School is over for the rest of the year for everyone - globally.

There may be many reasons to be reluctant to close schools.

Some kids get a lot of their food from school and go hungry when school is closed.

A lot of parents are dependent on school as de facto daycare and can't afford to pay for childcare when school isn't in session.

This is a problem that the city already faces during every school vacation and for 2.5 months every summer. Surely there must already be some functioning solutions. (For example, many NYC schools serve breakfast and lunch to children under 18 throughout the summer. I'm not sure how the lack of childcare is handled during the summers.)

why would you need / how would you get

childcare when we're all quarantined at home?

If the parent isn't being ordered home yet by the government, state law says "Your child is too young to leave home alone while you work" and they shut the schools down under circumstances where you will find it nigh impossible to get daycare at all because the entire city is dealing with the same issues, this could get you fired (or charged with child neglect if you go to work and leave your child home alone).

Lots of people are amazingly callous, but some aren't. Some are reluctant to pull the trigger on a decision like that, knowing how many people will get caught in the crossfire and have their lives essentially ruined even if we magically come up with a cure for the virus tomorrow.

This is actual happening to a friend. She has a toddler daughter, and two elementary age children.

School is cancelled, but she is expected to come to the office on Monday.

She works for the school board as an administrator.

Is that realistic? School being done for the whole year (basically the remainder of this semester up until June). That just sounds so other worldly to me.

If colleges why not schools

Panic is turning out to be extremely expensive for all of us.

Mitigating panic at this point seems more important than the virus.

I would say this is an engineered crisis. The mitigating approaches most of the world is taking don't make sense practically speaking.

At this point I’d consider it more likely than not.

Ohio governor said that most likely schools will be closed for the calendar year.

No he didn't

>Gov. Mike DeWine says it’s possible Ohio schools may be closed for the rest of the academic year.

https://pittsburgh.cbslocal.com/2020/03/15/ohio-governor-say...

Many institutions are closed (or moved online, e.g., education) for beyond 2 weeks. Some schools within the UC system are fully online through end of May.

Moderators: Here is the direct (non-paywalled) announcement from CDC:

https://www.cdc.gov/coronavirus/2019-ncov/community/large-ev...

This should be at the top

Put off for 8 weeks. Let's make the assumption that people follow the rule and things seem to go well and we get to May 10th. What will they say for the next max size gathering? 250? Small ramp ups? Or do you think they'll continue to say stay below 50 and the 8 week time limit is all that can looked ahead to?

We really need well run prediction markets on this. Getting more accurate forecasts on this is incredibly valuable.

I would love, love, love to learn more about whether and how China is rebooting and how that is going. Haven’t seen much reporting on it. Aside from Apple’s plans to reopen their stores there.

It looks like they're using slave labor.. oh sorry, forced labor while their families are held back in re-education camps:

https://www.extremetech.com/extreme/306909-report-china-sell...

Outside of Hubei, most people are back to work in some form or another now.

Throughout February white collar workers worked from home. Since March we've been allowed back to the office, although there are draconian restrictions (must not sit at same table, must wear mask, must report temperature etc). Schools are still closed so many parents continue to work from home.

Blue collars have been going back to work for several weeks, although I imagine they are facing similar or even harsher restrictions than white collars.

I think pink collars have suffered the most of everybody. Many restaurants have reopened, but in my neighborhood it's only this week that some barbershops reopened, and there are still no bars open, no movie theaters, no events venues etc.

My guess would be the country is about 60-70% back to work now, but those who are back are definitely not operating at maximum efficiency due to the ongoing travel restrictions, testing restrictions and closed up schools.

I would urge people in the west look at other countries in East Asia that handled this without a massive lockdown. China is not really a great example to follow.

I want those in leadership positions to stop saying “should” and start saying “must”.

I suspect they are worried about backlash related to freedom of assembly or freedom of religion.

Only thing we can do now is stop people from leaving their house for the next 4 weeks. We don't even have any testing capacity, nation should be shutting down till we have the means to constrain the virus.

Yeah, that would cause many times more deaths than Coronavirus ever would. Unsurprisingly, people still need food and medicine to survive.

Worked for China. If we don't do anything we'll have 7% mortality rate that Italy is reporting.

Does that mean you shouldn’t gather on, oh say an airplane?

This is a legitimate question IMO. You’re in much tighter quarters for far longer while flying most domestic routes.

Our family went on self quarantine a week ago because one of us is immunocompromised, but we have travel plans for a wedding in 6 weeks.

Train is probably no better although they could add more cars to seat people farther apart

I canceled an airplane trip I had planned for later this week precisely for this reason. I don't know that all flying should be stopped--I'm sure there are people whose reason for having to fly is urgent enough to outweigh the risk, and they should be able to make that decision for themselves. But I'm not one of them, so I'm not taking the risk.

I’ve read the onboard HEPA filters are actually pretty effective at filtering out a typical 0.1 micron viruses.

Right now, I’d probably hold out for a plane less than 1/3rd full. First class would probably be fine, too.

MA just announced a ban on all gatherings over 25 people. Restaurants are all now take-out only. Health clubs closed. All shows and schools canceled. Etc.. Currently this is through April 7th.

I hope the government is also planning to pay people’s rent, mortgage, electric, water, groceries, credit card interest, etc.

A friend of mine runs a small local restaurant. Not sure how he will pay rent. All of his servers are now temporarily unemployed and have no way to buy food or pay rent.

Another friend of mine is a personal trainer. Not sure how he will buy groceries next week.

The vast majority of the people most directly impacted by all this are essentially at zero risk of dying from COVID. And on April 7th it’s not like COVID will cease to exist...

“Locking everything down” is an incredibly damaging and nonsensical action for the vast majority of the population.

> at zero risk of dying from COVID

You're conflating the recorded fatality rate with the actual possibility for fatality, which is much higher.

The fatality rate is low among people 60 and under because the ones who suffer severe cases can reliably survive it with the aid of ventilators and round-the-clock medical care.

However, if the virus spreads enough to have a huge number of infections all at once, many of those severe cases that would have otherwise survived will die, because there's just not enough medical equipment or doctors for them.

See Italy, where the fatality rate is at a whopping 7.3% percent (much higher than even the 4.9% at the heart of the outbreak in Wuhan), because no measures were taken to control the spread until too late and so parts of the country have completely run out of ICU beds.

From what I've understood the mortality rate in Italy is artificially high because they are not prioritizing testing mild/asymptomatic cases. Until there are serological tests available we can only make guesses about the proportion of mild cases, but looking at the data from South Korea and Diamond Princess it looks like they make up the overwhelming majority of cases.

In Both SK and DP sick people got the best treatment. Without having access to enough respirators, CFRs would have been way higher there, which is exactly his point.

Definitely, lack of proper intensive care will pull the CFR in the opposite direction. But I don't think that is the main reason we see such high CFR's in Italy.

I've got a friend who's been profitably running a small business for a couple years who's pretty concerned. If they can't open, without relief for rent and loan payments, the place probably goes under in short order. (And it's a bummer to me because the business is unique for the area and has built up a nice community of regular patrons who won't have any real alternatives.)

>And on April 7th it’s not like COVID will cease to exist...

This is the most important part.

Its not clear whats being done to prep for the end of lockdowns. Once everything resumes so will the spread (all) viruses

We've seen in examples like South Korea that it is possible to keep the virus in check by doing extensive testing, contact tracing, and temperature checks.

We don't have those available right now and are looking at disaster if we don't lock down. Our testing capacity will grow significantly and by later we can take those measures and get back closer to normal life.

Unless the lockdowns are extremely effective, a large part of those who will get sick will already have been and thus immune. They can also be extended beyond April 7th.

Couldn't these people take out a low-interest loan for this time period? At least in Canada, major banks are reaching out to people asking to contact them if you experience financial hardship because of the outbreak.

I hear you absolutely that there needs to be economic assistance for the people affected here. They are going to be impacted well beyond the actual sicknesses. What I hope to convince you of though is that simply doing nothing and pretending people should continue to go out and about, could very well be like asking for good swimmers to stay back and keep shops open when there is flooding.

> The vast majority of the people most directly impacted by all this are essentially at zero risk of dying from COVID. And on April 7th it’s not like COVID will cease to exist... “Locking everything down” is an incredibly damaging and nonsensical action for the vast majority of the population.

Maybe, they are young and healthy. But unless they don't ever meet anyone with any comorbidities or advanced age, they will spread the virus to someone who isn't. Even if they are young and healthy and aren't aware of any risk factors, their immune system could overreact to the virus and kill them - its happened in china[0]. People who are afraid about the virus will not visit their establishment, or take classes from them, etc. This economic hit is not entirely artificial, it's coming for these people whether or not we close down service industry.

I think we have to take these drastic measures and also ensure the government treats this like the natural disaster it is, ready to restart the economy after the downturn by injecting cash and forgiving debt.

[0] https://www.nytimes.com/interactive/2020/03/13/world/asia/co...

The Democratic National Committee needs to postpone the primaries scheduled for this Tuesday.

I don't think a political party has that authority. It is up to state and possibly federal government (for most of it at least, not the caucuses).

The political parties can almost do whatever they want. The DNC fought for this in court after 2016. They can legally cancel all of the remaining contests and crown Jamie Dimon as the nominee if they so choose because they are a private organization, albeit one which has burrowed itself into the state and federal government.

I’d tend to agree but it could set a very dangerous precedent. I think that’s one of the few things that’s worth not postponing.

Well, society has never faced an epidemic during an election year, so unprecedented times might call for unprecedented measures.

Might as well call off the election then. These are unprecedented times after all.

If the election was held in April, yes absolutely you should. Unless you have virtual election options available.

1918. It wasn't a presidential election year, but it was for House and Senate.

This is false. The peak of the Spanish Flu was during the fall of 1918. The midterms that year went forward as scheduled.

Two states have postponed. Seems like it's a per-state thing, which makes sense, as Republicans are likely to have primaries, too, just not (well, not really) for the presidential race.

Apparently Austria just banned any gatherings of 5+ people. Are we in the US behind?

Grocery stores? Pharmacies?

Should be minimized, but obviously can't be eliminated. There are some services that can't be locked down, but that's OK as long as the community transmission risk as a whole is suppressed enough. Herd immunity isn't only about antibodies, the same mathematics works no matter how you reduce transmission rate.

Some stores here are limiting hours to something reasonable: it gives them time to re-stock and to clean. This seems not only reasonable but completely sane. Close down for 8 hours a day minimally so that they can clean stores.

Although it also makes the times they are open more crowded.

I can assure you the fear in the faces of the Walmart workers Thursday evening, as they had presided over emptier shelves every hour than any had ever seen, was fear of rationing more so than fear of contracting disease.

That was the last day before they limited hours.

Perhaps. Around here this isn't something unusual when a hurricane or crazy weather event is in the forecast.

Call it naive optimism, but hopefully in the next few days people will calm down and things might sort-of go back to normal.

This was much worse shortage developing more rapidly than the anticipated approach of more-accurately-predicted certain widespread destruction from closely looming hurricanes like Ike and Harvey.

It only takes a small fraction of the population to act overly cautiously in the face of perceived impending disaster, and you get throughput out the front door in shopping carts greater than they are ready to keep up with from truckloads in the back door.

Would be great if selection and available hours are broadened back to normal soon

>hopefully in the next few days

but until then it looks like rationing has already started in the big city.

Within about the last 4 hours, the White House has addressed hoarding food as the situation has become significant enough for them to go on record.

>_You don't have to buy so much,_ Trump said at a news conference. _Take it easy. Just relax._

>Pence urged Americans to only buy the groceries they need for the week ahead.

While Dr. Anthony Fauci,

>the government's top infectious disease expert said he would like to see aggressive measures such as a 14-day national shutdown that would require Americans to hunker down even more to help slow the spread of the coronavirus.

Why were you downvoted. There’s nothing controversial in what you wrote.

They need to just bite the bullet and lock everything down. We are way, way behind the curve here and cases and deaths are going to skyrocket no matter what we do at this point. But if we lock down now, we might be able to see the numbers plateau in a few weeks.

Honest question because I’ve seen a few comments stating this without totally clarifying: What does “lock everything down” mean? Are you suggesting people be locked up in their homes for weeks or a month? Or just shutting down non-essential businesses and buildings? Domestic travel restrictions? I legitimately am asking not to be snarky or confrontational, I’m just trying to get some clarity on what people mean when they say this.

You'd only be allowed outside to go to work or to the supermarket or pharmacy. All other shops closed. So factories and office buildings mostly stay open, just more reduced (home office as much as possible). Every country has different limits currently. China indeed locked doors (with tape) to check if people stayed it, food delivery only through windows.

Yes, you're fairly accurate. It means cafes, non-essential retail stores, restaurants, etc. should shut down. People should only venture outside for groceries, medicine, or if their work demands it. Work that is non-essential should be put on hold. No non-essential travel, no going out for dinner, no casual shopping for goods, no hanging out or drinking with friends or family.

Stay at home as often as you can, reasonably. You don't need a curfew, yet!

Spain has drones yelling at people to go home if they're spotted hanging out even in parks and whatnot.

People should stay home unless they're getting groceries/medicine or going to work in a hospital or other piece of critical infrastructure.

Looks like China had something like this over 42 days ago:

https://news.ycombinator.com/item?id=22218495

But there was not widespread interest here at the time.

Edit: Who likes drones anyway?

What Italy's doing seems pretty close to the most you can do in a western country. It just took them too long to do it.

* Only stores open are grocery stores, pharmacies and some other essentials.

* No going out except to go to work or go food shopping, or a brief walk in your neighborhood, on your own.

* No weddings, funerals, church.

* No travel outside your town, except for work.

* Work from home if you can.

* Some companies, like Ferrari, are simply shutting down for a bit - they're not a key element in anyone's supply chain.

Austria has banned gatherings of more than five people.

Italy has closed all stores other than grocery and drug stores. All non-essential travel is banned. There's a short list of valid essentials, like taking care of aging parents; there are roadblocks, they'll make you fill out a form stating your purpose, it's a crime to lie about it, and they do sometimes check.

In China, every place you go you get your temperature taken. Go in a building, get on a bus, they take your temperature. Show a fever, they take you to a dedicated fever center, where they check you for flu and bacterial infection. Come up clear on those, you're waiting four hours for a covid-19 test. Come up positive, you're there for the duration. You don't go home to your family because they've found 80% of transmissions are in family clusters.

Sounds worse than coronavirus.

It's temporary, and it's not worse than mass unnecessary deaths because there weren't enough ventilators.

Would you say that to someone whose loved one died?

When it turns out auto deaths drop, does that mean the shutdown goes on for ever? What will you say to the family of the first auto crash victim after the shutdown is lifted?

I do think it’s important to consider the pros and cons of any given policy, but I think this comparison is a bit extreme.

There are about 35k car crash deaths in the US each year [0].

I’ve seen estimates for total infection rate all over the map. Conservatively (?) if 30% of the US population is eventually infected and the fatality rate is 1%, that’s 1 million people, and basically two orders of magnitude larger for a comparable (?) time period. If we don’t do more than we currently are to limit transmission, these figures don’t seem that implausible.

Auto deaths are still a huge problem, but we can take more targeted action like improving transit coverage.

https://en.m.wikipedia.org/wiki/Motor_vehicle_fatality_rate_...

For some more perspective:

Italy has 3,333 deaths from car accidents per year. Currently 0.04% of Italy has confirmed covid-19. They have 1809 deaths from it.

And that is exactly why this is enforced on a state level and not left up to the individual.

Because the individual makes the wrong call for the whole.

You can isolate the individuals who are infected and misbehaving instead of the whole state.

Saying the individual makes the wrong call for the whole is remarkably stupid. The West is built on correct decisions for the whole by individuals.

Mindless politics.

COVID-19 is a smart disease, it comes off as a mild disease at first but it can still spread easily. You can even spread it without feeling symptoms yourself. If a person feels too ill to not be moving around, it would already have passed the virus down to many contacts.

Social distancing is therefore vital when patients keep coming out of nowhere. If there's a group of people they could easily spread the virus before they even know. If people don't listen, it may have to be enforced for public safety. It's the approach China, Singapore, and South Korea have done and succeeded in various levels.

If you're young and healthy, I can totally see how a lock down might feel worse than the risk of getting the coronavirus.

But it's not just about you. It's about the elderly, the sick, the weak around you. Even if you end up fine after getting the disease, you're going to transmit it to other people, directly or indirectly, who may end up dying because of you. That's what R0 is about.

So yeah, a lock down will suck for you, but I hope it makes you feel better to know that it will help save someone else's life.

Here are the details of Austria’s lockdown, for the curious: https://fm4.orf.at/stories/3000031/

I’d also like to see a lock down that doesn’t completely throw away our civil liberties. This is a serious issue, but I don’t want to be locked at home because we’re fighting a “war on viruses” twenty years from now

I worry about this too. I can’t believe you’re being downvoted.

I hate to say it but this whole thread gives me the vibe of democracy dying to thunderous applause.

Exactly! The "lock it all down" attitude has a heavy streak of unthinking authoritarianism to it that makes me very uncomfortable.

Reasonable precautions? Of course. Going nuts and disrupting everyone's lives and businesses like that? I'd rather not.

> I'd rather not.

Every other nation would rather not too but, as soon as every single hospital collapses due to the sheer volume of cases (it's really that bad)... oh, you'd all rather yep, just like we did. It doesn't look like the US is going the South Korean way.

And when I say "the hospital collapses" I really mean it cannot even take care of other emergencies. There are not enough ICU beds nor ventilators. Period. Normal operation is mostly halted too (I know this from first hand).

The worst is I know you won't listen, just like nobody else listened until it was too late. Quote me on that.

As I see it, you have a choice between three options.

1. Go nuts and lock everything down, Wuhan-style. 2. Be really competent at testing people, tracking everyone they've come into contact with over the previous ~2 weeks, test them too, and recurse. South Korea/Singapore-style. 3. Accept that ~60% of your population will get the virus and take the ~million deaths.

Obviously 2 is the best choice to take, but in the absence of competent government, you will inevitably get overreaching government because reasonable precautions taken by mediocre government DOES NOT WORK!

60% of your population will get the virus and take the ~million deaths

this implies 0.5% fatality rate. That's about an order of magnitude off.

You're right. I chose the optimistic end of fatality estimates because that's the conservative choice (for making the point I was making) but given that infrastructure will collapse in this scenario the true fatality rate is almost certain to be a lot higher.

I don't think there's enough data to say for sure on this in the sense that outside of S Korea, very few asymptomatic people have been tested.

Not according to S Korea

South Korea's infections have all overwhelmingly come from the same religious group, which tilts heavily towards the 25-35 year old demographic. People in that age group have a very low chance of dying from the disease.

South Korea has kept their infection rate low enough that it doesn't overwhelm their hospitals. The fatality rate is more like 5% if you can't get treated because the hospital is full.

I would wager that a 0.5% mortality rate is closer to the “real” rate than the 5% figure.

Look at South Korea. Do you see a 5% CFR there? Of course not.

> As I see it, you have a choice between three options.

You left out a fourth option:

4. People exercise common sense and take precautions on their own initiative to minimize their risk.

You don't have to wait for the government to tell you what to do.

You can look around to see how realistic that fantasy is. People are notoriously bad at risk assessment and in many cases the costs are borne by other people: those healthy 25 year olds hitting the bars all weekend probably don’t have much to worry about, but that’s almost certainly not true for everyone they cross paths with during the period where they’d be contagious.

This is exacerbated by the political angle: once a huge, well-funded and entrenched propaganda system picked this up, it became inevitable that there’d be a lot of people who will take inordinate amounts of personal risk because they think doing so is somehow sticking it to liberals. The latest NBC poll showed a stark partisan divide on even basic personal safety measures:

https://www.nbcnews.com/politics/meet-the-press/sixty-percen...

People are hoarding toilet papers and you expect them to somehow channel knowledge through common sense and magically understand which places/activities to avoid?

> People are hoarding toilet papers

Yes, this was the oddest thing I noticed while shopping for necessaries. Every single place I went to was totally cleaned out of toilet paper. Other paper products were depleted but not completely out, but TP--nada. I don't get it.

Its a symptom of those who have the virus, a intense need to collect toilet paper.

We can pinpoint the start of a virus in Wuhan China, and a global supply chain of toilet paper by competent western companies, with accountability and regulations to follow cannot supply a single reason why there is no TP. It's a joke.

Ah, yes, the "people will magically stop being people" approach.

All the people I know are taking common sense precautions (including my wife and me). Do you know a lot of people who aren't?

I'm taking common sense precautions.

There are parents at my kids' schools rolling their eyes and planning playdates. The local ski hill closed and people are complaining falsely "it's less lethal than the flu". There are people filling bars all over the country.

It doesn't take all that many of these people to flood the hospital ICUs - which already run pretty full in normal times - well beyond capacity.

I do. A shit ton. Most people I've talked to, in fact. Not that it matters who you or I know. Option 4 is the same as option 3: do nothing like the UK. People will act in what they perceive is their own self interest. For most people, that does not align with what's good for society. It's too late for mass testing. There's only one option: lock down.

A lot of countries thought they were taking that option like Italy, Spain, the UK, and the US. But eventually, Italy and Spain realized that there was no option 4 and they'd msitaken chosen option 3 so they switched to option 1.

> A lot of countries thought they were taking that option

At least in the US, I think it's too early to tell what the outcome of that option is.

Yeah, the issue is that the long lag time between infection and hospitalization combined with short doubling times means what once we order a lockdown it could get 20x worse before it gets better.

The die was cast well over a year ago, but the exponential function had us proper fucked a week ago.

We are not solving this through cleverness anymore, if it was ever on the table.

That clearly isn’t happening, though.

If you act early when total cases are in single or low double digit, 2 is a choice you can make. But for most of the world, that option is gone. Now the choices are 1 and 3.

I like choosing lock-down to reduce no of wild cases to a small number followed by option 2. I believe that is what they are planning in Wuhan and China. They'll lift off the lock down gradually but will continue with aggressive monitoring/testing and tracing. This will bring back the economy while still keeping the risk of epidemic.

I've been thinking this is a good test run to see how much authoritarianism the Western governments can get away with. If this turns into part of the yearly flu (which I've been hearing is getting more likely), then the 'war on viruses' could very well be a thing.

This. I live in China and while it is great that my city has only seen a handful of new infections over the past month, there are still fences up around neighborhoods, checkpoints everywhere, nervous cops doing "stop and frisk" to confirm people have valid travel passes etc. When I look at Taiwan, South Korea and other countries that have managed this outbreak without an extensive lockdown, I know what I'd prefer.

Yeah, sure, we would all have preferred to have responsible politicians who handled this correctly. Guess what? That ship has sailed. Most countries have "leadership" that handled this abysmally and now we have to deal with all this crap in order to flatten the curve until there are treatments and vaccines available.

My mom and dad are 73 years old and I don't give a damn about someone's tin-foil-hattery about "fighting the war on viruses 20 years from now", if I can keep them from dying. Go read some first-person accounts from people living in Italy, not just the ones about the roadblocks and forms you have to fill out, but also the ones from people who couldn't even say goodbye to their loved ones who died or the ones from HCWs about the collapse of their hospitals.

All of us who are pissed off about the lockdowns should hold on to that anger and express it fully after we have to stop worrying about our parents and grandparents being left for dead.

I don’t think it has to be a tinfoil approach though. I just mean, if we are going to restrict people, have aggressive sunset provisions on those orders (or poison pill the bill somehow to get more incentive to repeal it as soon as we beat this)

People are eager to give the government power when they're scared. You can feel the panic in the HN threads -- at the end of the day, most people are herding animals. A free society can't effectively force a quarantine, outside of the voluntary recommendations already being provided for social distancing. That seems like a trade-off many would find reasonable if the plague wasn't currently on their minds (2% chance of dying in a plague every century in exchange for having civil liberties the rest of the time).

What a free society could do is massively incentivize and subsidize new drug research, while lowering the barrier to entry for human trials. Right now this is only being done manually in the US with a few drugs and major players, such as Remdesivir, instead of allowing a systematic approach for non-major players to skip the line, too (e.g. university research labs).

The quarantine in China will end at some point, but you claim it won't end in the US if we give the government that power, a power it already has. Which one's the free country again?

The US is the free country, because we have no lockdown.

The US constitution gives the federal government the right to implement a quarantine and enforce it:

"If a quarantinable disease is suspected or identified, CDC may issue a federal isolation or quarantine order.

Public health authorities at the federal, state, local, and tribal levels may sometimes seek help from police or other law enforcement officers to enforce a public health order.

U.S. Customs and Border Protection and U.S. Coast Guard officers are authorized to help enforce federal quarantine orders.

Breaking a federal quarantine order is punishable by fines and imprisonment."

https://www.cdc.gov/quarantine/aboutlawsregulationsquarantin...

They’re just referencing the commerce clause. Can the commerce clause supercede the bill of rights?

Commerce clause has been used for all sorts of 2A regulations.

If you're thinking of the gun free school zone law, I don't think it quite supports your point. I believe the Commerce Clause was used to justify federal regulation of gun purchases/ownership, as opposed to it having to be a state law. It was not used (I believe) in any way to abrogate the rights afforded by the Second Amendment. I could be wrong — I never practiced law in this area — but I can't remember ever hearing about the Commerce Clause being used as a limitation on the Second Amendment. That is effectively what would be required here.

The federal government regulates firearms under the commerce clause the same whey they regulate pharmaceuticals under the commerce clause. The difference is they can outright prohibit marijuana and not rifles because the latter prohibition would violate the second amendment.

The commerce clause doesn't override the second amendment (or any other part of the bill of rights), there are only cases where a particular amendment was found not to apply.

What you're looking for is emergency powers, but they're not actually in the constitution. In practice what has happened is that Presidents do whatever thing in an emergency and then get sued over it after, and typically lose, but by then it's years later and whatever temporary measures they ordered in the middle of the emergency are long since discontinued.

It's kind of a kludge, but it also kind of works, because it keeps the emergency measures from extending longer than it takes for the courts to catch up to it, and also gives the victims of rights violations the ability to get compensated after the fact for being done wrong in the midst of a big mess.

The Federal government requires local cooperation to enforce any such orders, they operate at the pleasure of local authorities. This limitation on Federal power shows up routinely in other matters when local authorities disagree with Federal enforcement actions. Hence the reference to CBP and the Coast Guard, which do have authority to enforce such things at points of entry into the country.

There are also strong restrictions on the scope of quarantine orders that would be allowed to circumvent due process in emergencies.

Seems like the two are a bit mutually exclusive no? I mean lock down implies limiting movement, which limits civil liberties. I don't really see how you can have a lock down without limiting civil liberties.

I really hope we lock down fast enough that the total number of infections in the US stays below 1 million.

1 million infections is the point where we run out of ICU beds (ICU rate of 10%, US has 100k ICU beds), and that's the point where the death rate jumps from 0.2% to 3%+

of the infections that don't require hospitalization what is the average recovery time? seems like we should start seeing recovery numbers going up soon.

It’s hard to tell. Many cases are asymptomatic and a lot of people are being denied tests because they are rationed. But the data seems to point to roughly 1-2 weeks recovery time for unhospitalized cases.

> and that's the point where the death rate jumps from 0.2% to 3%+

Do you have a citation for that? We haven't seen a death rate of 0.2% in any population.

SK (which has the broadest base of testing), Diamond Princess (which offered a unique case study, where we could test every person), and epidemiological estimates are all closer to 1%.

Where are you getting the 0.2% number from?

Grandparent comment is almost certainly referring to the Case Fatality Rate. South Korea is a better example, due to widespread testing (there was a lot of self-selection on cruise populations).

CFR of 3% - 5% for unprepared areas is not unreasonable. 0.6% is closer to the South Korean experience. https://github.com/CSSEGISandData/covid-19

Yes, but my specific question was: where did they get a CFR of 0.2% from?

SK's CFR[1] is currently 0.9% (8,162 cases; 75 deaths).

I haven't seen any source (or reputable estimate) that indicates a 0.2% CFR. So I'm asking for a citation or reference for where that number came from.

[1] data from John's Hopkin's tracker: https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594...

Death rate != CFR.

CFR is the fatality rate for diagnosed people and it's gonna swing wildly depending on how many people are tested and diagnosed. And considering how this virus affects young and healthy people, there's good reason to believe that a lot of people get infected and never seek out medical assistance and never get diagnosed.

Even the best numbers we have are often skewed and misleading - as an example, we have a lot of good data from the cruise ship quarantined in Japan, but cruise passengers do not match the demographics of the general population.

Chloroquine may explain why South Korea has low CFR

https://youtu.be/U7F1cnWup9M?t=891

Really promising and excellent video. I hope chloroquine (or hydroxychloroquine) proves to be effective in emergency clinical trials. And that it can be readily sourced for upcoming patients if so.

All researchers, doctors should see this video & cited papers to evaluate potential.

IIRC Diamond Princess tester people gradually over a prolonged period. They declared that anyone who tested negative at any point was obviously still negative when they got off the ship.

From the CDC:

"but a broad range of 0.25%–3.0% probably should be considered."

https://wwwnc.cdc.gov/eid/article/26/6/20-0320_article

But even that isn't really responsive.

The parent said the death rate (without care) jumps from 0.2% to 3% (with care) as if both numbers were known.

An article saying that the death rate (with care) could range anywhere from 0.25%-3.0% seems...like not a solid foundation to make the claim the parent commenter made.

The issue is that infections are not going to be evenly distributed inline with ICU beds. For example, NYC has 3,000 ICU beds, of which 80% are already occupied (65 by coronavirus patients based on the latest numbers). Meaning there are 600 ICU beds open right now. With a 10% ICU rate, that's only 6,000 confirmed infections in a city of 8.6M for the hospitals to be overwhelmed.

Sadly, all of New York has 3000 ICU beds. New York City probably only has about half of those.

A huge portion of those beds need to be used for other illnesses besides covid19; the breakaway case number is therefore much lower than 1M.

The US has major public leaders [1] and news organizations actively suggesting to people this is overblown and that they should go continue about their normal lives. We are so completely far from that step happening on a national level.

Edit: Source added.

[1] https://www.motherjones.com/coronavirus-updates/2020/03/devi...

What's the most recent example? It seems to me as though any diminution of the crisis stopped this weekend.

Literally several Republicans today. The Governor of Oklahoma tweeted a pic of himself at a busy restaurant last night (https://pbs.twimg.com/media/ETHs_hQUcAAu3Ep?format=jpg).

Sheriff David Clarke, who has nearly a million followers on Twitter just said this a few hours ago and got thousands of retweets and favorites:

> It is now evident that this is an orchestrated attempt to destroy CAPITALISM. First sports, then schools and finally commercial businesses. Time to RISE UP and push back. Bars and restaurants should defy the order. Let people decide if they want to go out.

> GO INTO THE STREETS FOLKS. Visit bars, restaurants, shopping malls, CHURCHES and demand that your schools re-open. NOW! If government doesn’t stop this foolishness...STAY IN THE STREETS. END GOVERNEMNT CONTROL OVER OUR LIVES. IF NOT NOW, WHEN?

https://twitter.com/SheriffClarke/status/1239324440934133760

These people are psychotic and should be expelled from polite society.

You shouldn't be downvoted for sharing facts.

He didn't just share facts, he expressed an extreme personal opinion.

I don't think it's extreme. He's quoting someone demanding that people ignore all public health information and engage in insurrection. We should stop listening to people who are actively and willfully undermining public health.

I think that popular figures trying to exacerbate a pandemic by sowing public distrust deserve a bit of vitriol in response. It's not a subject that's really amenable to polite argument; Sherrif Clarke is killing people, as surely as if he walked up and shot them in the head.

As OP -- One of my really good friends (and a mother of 3) is currently undergoing chemo to knock out her immune system and prep her for a bone marrow transplant since she discovered she has severe aplastic anemia on Christmas, several of my family members work in primary care in hospitals, I have a large very close-knit family with ~10 uncles/aunts with significant Covid19 comorbidities and a 90-year old grandfather who lives in an urban center. If "Expelling people from polite society" for directly endangering all of their lives is extreme then I'm glad I didn't share my true opinion of what should happen to these charlatans.

Oh nonsense....he correctly noted that a person with no medical training was trying to use fear and political motivations to get followers to do things that put them in physical danger.

That is not an opinion much less an extreme one.

I only see facts.

Tweets thankfully deleted by twitter.

Here's somone running for public office in Clark County, Nevada trying to score points against AOC: https://www.reviewjournal.com/news/politics-and-government/c...

That's kind of problematic. The population in New York City is much denser than in Las Vegas and the number of infected much higher, consequently you might need a lockdown in NYC while in suburban Las Vegas everyone can just retreat into their McMansion on Cobblestone Court Road and watch Foxnews for two weeks.

As a politician you can angle for votes by mocking the healthcare system in Lombardy, one of the best in the world, because your local hospital won't be hit quite as hard, while the healthcare personnel on the frontlines risks infection with coronavirus. The free-rider problem in politics in unsolved, it seems.

Who is saying this?

Sunday morning TV show, Fox News, Devin Nunes.

https://www.marketwatch.com/story/its-a-great-time-to-go-out...

One of these is not like the others

I am at a loss. Fox News hosted Devin Nunes on a Sunday morning news show. Did I miss something?

I totally misparsed your comment lol. Definitely thought you meant those as three different things.

This is exactly how it happened in Spain. Please guys, consider it, most media is just nonsense, people pretending to have knowledge about stuff they don't know shit about. Most of you here are smart enough to know what's an exponential, logit and even run your own SIR model.

You'll be in a situation where people will die by contagion of other people who isn't even aware they are infected. You might infect your loved ones.

If you don't lock down now, it will be bad.

Spaniard here. I'm not looking forward to the >2 months I expect of lockdown but it is what it is. Why is everyone so cocky? It will happen to your country too, just like it happened to us other countries.

This post (it's parents)!

The US already moving that way in baby steps but things will certainly get there. That it isn't there already is already bad but I can't see this taking more than a few more days.

This. I've been very very angry with the official response until last week because this is not really hard to estimate and the numbers were there already. I'm quite happy with the recent tough measures, they make sense and I expect/hope they're going to work. I don't think we have much of a choice here, it's either this or a toll that's simply unacceptable if you have the means to avoid it. And you have them: don't ignore common sense because of political choices or the excitement of gambling. Sometimes the obvious thing to do is the right thing to do. Don't try to be clever with this, this is a ruthless chain reaction headed to kill/maim millions, and not in the abstract way doing what needs to be done might or might not result in.

I've also been getting some too scarily close fitting done (not sharing that, it'd be irresponsible, this is not my job and I'm nowhere close to being an epidemiologist). I think the number of confirmed cases in Spain is going to grow appallingly this week and morale is going to be hit hard. Tiny in comparison of what we'd get if we did nothing about it, though. I also think (and hope) it'll start getting much better after that if we're effectively quenching contagion. I hope the authorities share their models with the public in order to give them a fuller picture. That might help psychologically.

At any rate, you don't have to wait for anything, you can start implementing social distancing and careful personal hygiene practices right now.

In a just society this would be grounds for negligence.

Older Republicans are the ones spewing and buying into this crap, which is not surprising, since that's where a lot of the "you'll pry my liberty from my cold dead fingers" attitude resides.

https://www.washingtonpost.com/politics/2020/03/14/older-ame...

I’m not an “older republican” but having been through post 9/11 changes, I am too of a similar opinion.

The answer cannot be a choice between “lose all your freedoms forever” or “the virus kills a million Americans”.

Probably closer to several million if stricter measures aren't taken, because the severe cases will overload hospitals and there won't be enough ventilation equipment and doctors to go around.

You have the freedom to take personal responsibility in a time of crisis. Despite the zeitgeist freedom doesn't have to be all about being dangerously selfish.

Trusting people to take personal responsibility and act appropriately has failed in every country so far. Even Switzerland.

Do you believe the US is special in this regard?

Where did I mention any country? I only have to walk 3 mins outside my apartment in Berlin to find cafes teeming with irresponsible idiots. It's unbelievably demoralising.

You support going about your daily lives instead of social distancing to reduce the spread?

Here's California Representative Devin Nunes on healthy families visiting restaurants to help local economy:

https://thehill.com/homenews/house/487666-nunes-urges-americ...

Who knew? Electing badly can have bad outcomes.

The people that elected him probably don't and probably won't think this is a bad outcome.

The people who elected him are presumably on the older side, and thus the ones likely to die if this isn’t dealt with properly.

The Mayor of Austin and other City officials were still encouraging people to go out to clubs and restaurants after they canceled SXSW.

Stupid has no party.

I kind of get it. This is going to devastate cafes, bars, clubs, restaurants, and tons of other small businesses. Hell, I doubt our dog boarding place will survive. Until our government steps up and promises replacement dollars, mayors and even governors are in between a rock and a really hard place. These small businesses rarely have a spare 1-2 months of rent, let alone payroll, sitting around.

To be fair, that was a week ago, at a time when there were no confirmed cases in Austin. The mayor has completely changed his tune: https://www.kxan.com/news/coronavirus/full-interview-mayor-a...

You may say stupid has no party, but the hallmark of stupid is trying to pretend reality doesn't exist so that it fits whatever you said (sharpie'ing out the exponential growth curves won't cut it this time), instead of admitting you were wrong and changing as the facts require.

From that interview, sounds like he's set a headcount but otherwise still wants people to go out:

"We are not saying you shouldn’t go to restaurants, but we certainly don’t want any restaurants with more than 250 people, we have ordered that. If you are in a restaurant, try not to be on top of other people, increase the social distancing, social separation."

The French yellow vests are still rioting saying this is a move by the capitalists to lower stock values so they can buy in cheap.

Honestly it does seem to have a lot of blatantly manufactured steps added on top of a normal health situation. Australia has implemented a 50k fine for people who break curfew.

When did 1984 become reality for the public? This is not the stiff upper lip, we don't give our lifestyle away to foreign threats, classic western attitude. This is blatant politicking for a police state off the back of dead people. Nobody wants to live like this and sometimes you have to choose for yourself.

I predict that in less than 3 weeks, most people like you will have changed your minds. When the time comes (and it will), please look back at how selfish you sounded here.

There are more ways to deal with this crisis than are being implemented. A desire to live outside of lockdown is not synonymous with selfishness, even if that were my motive.

Are there legal issues here? Can the federal government just "lock down" random local stuff in an emergency?

The federal government can claim it affects "interstate commerce".

I mean, what if it's like a hundred people gathering in one place just to hang out? Or do you mean they should just make some baseless argument and let someone who cares sue later?

There is substantial Supreme Court precedent regarding this, Americans have a Constitutional right to freedom of travel on par with freedom of speech. Exceptions are extremely narrow and limited. I don't think people here realize how many times this has been reviewed by the court in cases the government deemed exceptional. This is not new territory legally.

The interstate commerce clause is fundamentally restricted in scope such that it does not violate fundamental individual rights i.e. you cannot use the commerce clause to restrict free speech.

The federal government used the commerce clause to restrict a farmer from growing wheat, and won in the supreme court.

Yes, it was terrible precedent but it also has no relevance here. If you could abrogate fundamental rights with the commerce clause then those rights effectively don't exist and the Supreme Court has consistently ruled on this. You can't use the commerce clause to infringe on the right of free speech, the right to bear arms, etc. This has been argued in the court many times and the outcomes have been one-sided in favor of the individual right.

Freedom of travel -- what we are talking about with a "lockdown" -- is a thoroughly adjudicated fundamental right per the Supreme Court. Using the commerce clause to restrict travel in various ways has already been rejected by the Supreme Court, repeatedly.

Well then we're screwed :(

But wait, haven't there been quarantines during past epidemics?

Read up on the National Emergencies Act.

The federal government can do so, once the President has declared a state of emergency (which, he has).

Is this act actually constitutional? It's not interstate commerce, and I'm having trouble recalling relevant emergency provisions in the constitution that would expand federal authority to local issues. I can imagine the Supreme Court ruling that it's a common-sense provision if someone tries to legally challenge it, but I'm not aware of the history.

You'd be surprised as to what constitutes interstate commerce. I've seen local criminals brought up on federal Hobbs Act charges for their participation in robbing convenience stores. The prosecutor made sure to note that the store was "known to engage in interstate commerce." Almost any business you can think of engages in interstate commerce. Think about it, where does the stock for the store come from? Where were the registers used to process transactions manufactured? Does the business purchase digital advertising? All of those are interstate commerce.

I'm not surprised, because I'm already aware the umbrella is rather larger than most people would expect. Nevertheless, it simply won't cover everything that we'd need covered from a public health perspective. So what happens here?

That only means the federal government can pass a law about it. It doesn't mean they can pass a law that abrogates other constitutionally-protected rights.

The commerce clause cannot be used to abrogate fundamental individual rights, people are seriously misunderstanding what can be done under that clause. There is a mountain of Supreme Court precedent that covers this explicitly, and the specific case of freedom of travel, and also covers attempts to use regulatory technicalities to do the same. The right of Americans to travel freely absent narrow circumstances requiring due process is settled law at this point. This may be inconvenient for anyone that wants to implement a lockdown but this is well-trod legal territory.

I think people are also conflating what the Federal government can do, which is very little, and what local governments can do, which is considerably more. Broadly speaking, the Federal government operates in an "advise and support" role, the legal authority resides with the States and localities. This is an example of where State sovereignty becomes very obvious. But even with the States exercising their broader powers, they are still restricted from violating fundamental Constitutional rights like freedom of speech, assembly, travel, etc.

Supreme count precedent only matters once a court case makes it to court.

Until then, the President of the United States can make an order, and if it is enforced by local authorities, it's defacto legal for the duration.

Not at all. Violating well-established legal precedent that has already been reviewed by the Supreme Court is an easy basis for the courts to place an immediate injunction of the effects of those orders.

This happens in many other contexts, there is no reason to believe it wouldn't happen here.

There is one big reason why the supreme court wouldn't overrule a quarantine order.

Freedom of assembly is our first amendment right. I’m not saying a ban doesn’t make sense but it needs to be by the book.

Freedom of assembly to petition the government for redress of grievances. I believe that is the only freedom of assembly we are guaranteed.

I think you missed the "and to petition":

> or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.

Public safety exceptions to the freedom of assembly are routine and common.

What do you realistically estimate numbers to be in 1 week, 2 weeks, 3 weeks, and 4 weeks? When will we see exponential case growth taper off?

I think it depends a lot on how many individual people take common sense precautions themselves, instead of waiting for governments to take action. Even if there isn't a ban on large gatherings of people, if you don't have a very, very urgent reason to attend one, I would say, don't. Cancel it, or postpone it to a better time. Other common sense precautions should be easily seen.

If enough people do that, I think we'll see US case growth start to taper off in a week or so.

A week? If you got I’ll this weekend or the last few days you probably won’t feel it for 10 days. We’ll probably see cases drop off in 3-4 weeks. But between them and now the vast majority will be without the need for a hospital visit.

We probably have about 200k sick people today. Few need help.

> If you got I’ll this weekend or the last few days you probably won’t feel it for 10 days.

The median incubation period is about 5 or 6 days, not 10.

> We probably have about 200k sick people today.

That's the big question that nobody really knows the answer to. If the actual number is indeed that high, then you're probably right that we won't see the rate taper off in a week. I personally don't think it's that high, because most of the cases identified to date are in particular clusters. If the virus had really been spreading within the population for weeks undetected, which it would have to be for numbers like 200k total to be possible, cases popping up now would not be clustered so much. At least, that's my read--but I don't think anybody really has a good handle on the actual spread of the virus at this point.

Yes. The US is 13 days behind Italy right now and headed in the same direction. [1]

California's governor just ordered all bars, nightclubs, etc, to close, and restricted restaurant to 50% capacity.

[1] http://archive.is/a1nkq

No, he was very explicit that he was not ordering those measures, but suggesting them.

[1] https://sf.eater.com/2020/3/15/21180845/california-coronavir...

That's wishful thinking by the restaurant PR industry.

"Newsom said the social isolation and bar directives were not an order, but that he’s confident they will be followed.

“We recognize that social isolation for millions of Californians is anxiety inducing ... but we need to lean in and own this moment,” he said."

In SF, it is an order for larger bars and clubs. Also for Santa Clara county.[1] Under California law, the county health officer has primary authority in this: "The county health officer may take any preventive measure that may be necessary to protect and preserve the public health from any public health hazard during any "state of war emergency," "state of emergency," or "local emergency," as defined by Section 8558 of the Government Code, within his or her jurisdiction." The Governor's direction tells county health officials to issue appropriate orders, which they are doing.[2]

[1] https://www.sccgov.org/sites/phd/DiseaseInformation/novel-co... [2] https://www.smgov.net/departments/oem/sems/proclamations-and...

Here's a table that showed up on Reddit a couple days that makes the correlation even clearer:

https://www.reddit.com/r/dataisbeautiful/comments/fiun99/oc_...

For the US, Italy's numbers are like looking 11 days into the future.

Except just about nowhere is like northern Italy’s situation. It’s apples to oranges. There’s so much more to it all than a Reddit Excel graphic meme.

This entire thing has become a meme and it’s mainly wrong. It’s a serious issue but these kinds of data analysis are just super wrong. They are missing all context.

Italy is an awful model. Look to cities like NYC or London for realistic worst case scenarios as they’ve had infections just as long. And they are the worst case as most places don’t have anywhere near the foreign travel or social proximity.

It will get much worse than now (it’s not even bad yet almost everywhere in terms of ICU PATIENTS). But this ridiculous idea that the Italian situation is going to replicate in most places is bad analysis.

Why do you think it's a ridiculous idea that the US might follow in Italy's footsteps? (Honest question, I'd love for that to be the case)

I imagine their thought is that, it spread to Italy and the other big US cities at about the same time (we have just not done as much testing). And that we have not had the deaths they had.

Sure, obviously, there's much more to it than this. But consider the HR manager who's looking at the latest CDC numbers showing a few cases in state and wondering why people like me are getting so worked up and begging executives to transition our offices to remote work as soon as possible.

For someone like that, I'm hoping this flips a switch and they get a glimpse of a troubling and increasingly dangerous future that's only a week or two away.

I'm reminded of the Daniel Kahnemann quote:

an algorithm that is constructed on the back of an envelope is often good enough to compete with an optimally weighted formula, and certainly good enough to outdo expert judgment

Unfortunately, the expert judgment in some cases may be from a decision-maker who takes their cue on current affairs from sports radio or, god help us, the President of the United States himself.

London or NHS barely tests and you can't get tested on request. I have been having pneumonia for the last days now and can't even get antibiotics for it. They don't let me visit my GP or the hospital.

I don't think anyone is suggesting that the situation in Italy is 100% accurately "going to replicate in most places". It's only an example to warn us of the kind of human tragedy that could happen if we don't get our sh*t together in the US.

No one cares if the theoretically more accurate number really should be 20K cases and not 50K cases in 10 days. The point is we need to act NOW rather than 10 days later. As Dr. Fauci said, it's probably better for us to be overreacting at this point than under-reacting. [1]

[1] https://thehill.com/homenews/sunday-talk-shows/487639-fauci-...

Can't use case numbers in the US since we aren't testing unless you're dying of pneumonia.

I have many friends who work hourly wages and do not have enough in savings to last more than a month without work. The full lockdown you are advocating for could cause significantly more devastation than it prevents.

And it's nice to think that everyone will just stay home and quarantine until this blows over, but I'd be surprised if a majority of people actually did that. At some point the "lockdown" strategy produces diminishing returns.

1) Your friends are going to face that situation regardless. It's not like if we don't shut down now, things will be fine in a week or a month. We will shut things down, it's just a question of whether we do it proactively or reactively. And proactively has already passed, but we still could shut down before we're absolutely forced to.

2) Don't make it optional. If ever there was a use for the national guard, this is it. Put police and soldiers in the street. No one goes out unless it's for food or healthcare, on penalty of heavy fines and imprisonment.

Again, this isn't optional, and we will do this. Look at Italy. It's just a question of whether we do it now or in a few weeks, when our hesitation will have cost tens of thousands of lives and even more economic ruin.

Italy is a unique situation with the world’s second-oldest population.

People continue analogizing without acknowledging that confounding factor.

I want no part of an armed national guard enforcing a nationwide quarantine. And I’m guessing the 70 and 80 year olds who are most affected would rather roll the dice than watch our country descend into such an autocratic look.

Well, we’ll get to see it play out in the next few weeks, won’t we. France and Spain aren’t making me feel better. And given how unhealthy the American population is, I think you’re being incredibly cavalier with other people’s lives.

(Not GP)

I think you’re being incredibly cavalier with other people’s personal freedoms if you’re advocating China-style totalitarian lockdown in response.

No, I don’t think having the national guard enforce a national quarantine is a good thing.

Lots of people seem to have this delusion that we will eradicate this virus, or that we cam hold off until the vaccine is ready. That’s a fantasy. The entire world will be exposed, and thus our job is just to slow the rate enough that we do not run out of medical capacity. That’s all.

—-

Seriously tho, it shocks me that people are acting that this is an extinction event. It’s not. My layperson napkin math makes me predict around 1-3 million dead in America by the time this has run its course. That’s a terrible figure but it’s very different from losing 100 million.

Again, I support social distancing and flattening the curve, but I oppose all forms of compulsion in this matter. People seem to really be losing their sanity here...

No they just think that 1 to 8 million dead is really bad, and are willing to give up some freedom to save a ton of lives.

I understand that.

I will note that the phrase “some freedom” is slippery. Really we’re talking about ceding the fundamental freedom of movement.

We already have these limitations in place now don't we? I mean we can't go into private property, because it's someone else's property. Your right to swing your fist ends where my nose begins kind of deal.

If you're free to move around while sick, doesn't that in essence limit my freedom to go to the same place? If you're infected you are in fact a danger to those around you.

You should note that:

* quarantine laws and powers have existed for thousands of years in all forms of governments, and much more draconian steps have been taken in this country in the past -- which were obviously reversed after the crisis.

* speaking of, these laws & powers have been on the books for quite some time -- not exactly in a sub-basement with a burnt-out lightbulb and a sign reading "Beware the Leopard" :-)

* the majority of people are OK with lawful extreme public health measures in the face of an extreme pandemic; that number increases as more people get sick and die from the disease.

* most people also uniformly agree that we don't have time right now to re-litigate the hundred years of legal analysis, court decisions, and public health science that led to modern public health law just for the benefit of the latest generation of libertarians.

* most importantly -- flippantly shrugging off the death of a million (or THREE million) of your countrymen as an argument against closing restaurants is going to make most people think you're a sociopath. Unless you're in an impermeable bunker with a literal lifetime supply of every need and no human relationships, the rapid death of millions of Americans and the attendant culture and economic shocks should upset you, or at least make you anxious about the future.

Stay healthy, and good luck with those back-of-the-napkin epidemiology and civil rights analyses!

Sorry for the late response here. I appreciate the points you raised, but could do without the snarky comments. They distract from the argument, IMO. Particularly when you utilize strawmans like so:

> flippantly shrugging off the death of a million (or THREE million) of your countrymen as an argument against closing restaurants

The above is a blatant mischaracterization of my position. You really did show that straw effigy who was boss though :P

Age is not the only factor. A false sense of security affected Italy as much, if not more. Isn’t japan the oldest? How do you explain their relative success???

Autocracy is a bogeyman just like Socialism. Sometimes you have to temporarily rally as humanity for the good of the whole and give up your individual “freedom.”

I strongly disagree with imprisonment here, but I can get behind fines.

They only get imprisoned in jails if they opt not to be imprisoned at home.

Re 1) Why would my friends loose all of their hours if their employers don't shut down? My friends are young enough that they would likely recover quickly from the virus if they got it.

Re 2) There is no way the police has the manpower to enforce a shutdown like that, even with help from the national guard. There would be riots. And where does food even come from in this hypathetical situation?

> Why would my friends loose all of their hours if their employers don't shut down? My friends are young enough that they would likely recover quickly from the virus if they got it.

There is a chance your friends may lose their jobs in any case given how this is being managed. It'll be interesting to see how people treat each other in the coming weeks when people suspect they've not been social distancing. People are just going to get more entrenched in their politics.

> where does food even come from in this hypathetical [sic] situation?

Where does the food come from that the National Guard are delivering in New Rochelle? [1] A point that isn't well made in many of these threads is that these shutdowns are targeted. The behavior of people in the neighboring areas will also be impacted without being part of the shutdown, and these only need to go on for a limited period.

I am curious how long the National Guard, etc. have remained engaged after other deployments. Do they need reauthorization after a certain timeframe? How does their engagement prevent better alternatives getting engaged? Someone has to have researched that, but I've never seen it brought up in discussions like this one.

[1] https://www.buzzfeednews.com/article/katebubacz/inside-new-r...

1) The employers will shut down, guaranteed. It's just a matter of whether we do it now or a few weeks from now. Just keeping everything open and running through this is not an option. The only way you can do that is to have an incredibly competent government that is on top of testing and contact tracing at all times, and that ship has long sailed. Look at the UK to see how this "keep things running and just protect the vulnerable" strategy plays out. It's already starting to break down and they'll be in lockdown in a week or two, but many more will ultimately die than they would have if they had locked down before they were forced to. It's not a question of if we lock down, but when.

2) Disagree. Again, look at Europe right now.

> Put police and soldiers in the street. No one goes out unless it's for food or healthcare, on penalty of heavy fines and imprisonment.

OK, but how will people without savings or adequate credit pay for food and healthcare?

Also, how can people stay at home if they're homeless?

Will governments step in with free food, and rules against eviction?

Yes, the government should step in with those measures regardless. Without that, this isn't possible. Then we are stuck doing nothing like the UK, despite having almost two months lead time on this.

This is fundamentally a problem with our society. I'm not sure what happened to workers in authoritarian countries that are locked down (ie. China), how are they supporting their workers that can't work?

We can't have a modern society where your choices are work and spread a deadly virus likely overwhelming hospital facilities or not work, fail to pay rent, become homeless and starve.

People in China tend to save more than living paycheck to paycheck like Americans.

Singapore has been paying S$100/day (about US$70/day) for anyone issued a quarantine/stay-home order [1]. They've been doing extensive testing and contact tracing though, so they haven't been doing general lockdowns, just targeted stay-home orders to contacts of tested-positive people.

[1] https://www.mom.gov.sg/covid-19/frequently-asked-questions

If we do a "full lockdown" like this, there needs to be a suspension of basically all bills (mortgage, rent, etc.) for the period of the shutdown +20%.

This obviously doesn't work if "suspension" means you don't pay the provider, because then they can't in turn pay their employees etc.

What could work is some kind of UBI which people could then use to pay their bills.

Good point.

Are loans just going to suspend interest and payment dates extended? I sure hope so because if not, there is going to be a wave of foreclosures and closed small businesses not seen since the 2007 crash.

Personally I am in deep water because Airbnb is allowing 100% refunds without any compensation for hosts!

Boy, intelligent enough to recognize the economic consequences of this quarantine, and the consequences if we don't quarantine?

Sounds like you need to register a vote for one Mr Bernard Sanders. It's not too late.

> The full lockdown you are advocating for could cause significantly more devastation than it prevents.

The financial hit will be very real, but there can and will be mitigations down the line. What do you think are the chances that city, state and federal governments are all just going to let people starve in their homes? For example, the California state government has promised to keep paying teachers and school staff despite school closures. Not to mention companies, organizations and individuals. Many tech companies are continuing to pay maintenance staff despite office closures, for example.

As for the devastation that it prevents - well, many unnecessary deaths. The government might be able to pay you a portion of lost wages, give you a loan or reduce your taxes this year, but it can't bring back your loved ones if they die from the coronavirus.

> I'd be surprised if a majority of people actually did that

There are always going to be idiots and morons. But I think if cases and deaths skyrocket over the next few weeks, as is currently expected, the number of people flouting the quarantine is going to go down pretty dramatically. Not only will people become more aware of the risk, but more businesses will be closed so there's less incentive (e.g. all bars and clubs closed in several states, Starbucks is now takeout-only in some places, attractions like Disneyland closing down etc).

or they need to figure out a way to test everyone, or at least a significant sample, regardless of symptoms so we can get a baseline.

I am not comfortable with the tourniquets being applied to our open society.

boy, good thing that we're restricting testing until trump's extended family can profit

https://www.reddit.com/r/politics/comments/fj2bmm/president_...

I thought all of this was unnecessary until I met a few people who say "are not afraid" of the pandemic and continue going out to parties and reunions. The US needs to lock everything down because of people like that.

Shutting everything down in favor of quarantine is very problematic. If child care and schools shut down, no parent can go to work. Unless they get someone else to take care of their children, in which we've effectively bypassed the lockdown entirely. If this is the solution, let's hope most of your doctors, nurses and their auxiliaries don't have kids. And that is to say nothing of the economy of lockdown.

Herd immunity is a very real thing, and considering most young people can get affected with rather mild symptoms, perhaps a steady infection rate to build up immunity among the population is way better than hoarding and locking down.

The "herd immunity" theory seems to be the UK's approach, but it's going to fall apart quickly, I predict. They'll be in lockdown within 2 weeks.

In NYC, they just decided to shut down schools but they're providing childcare to essential personnel still, as well as meals and online education for school aged children.

you d think that public service announcements would not be put behind a paywall

The CDC web site is not behind a paywall.

Public service announcements are meant to be broadcast by the media

PSAs are meant to be broadcast to all audiences.

On a subscription service, the audience is the subscribers.

There's no requirement that I'm aware of for subscription services to offer non-subscribers any content of any sort, including PSAs.

It's 5 in Australia

Did you mean Austria?

https://www.bloomberg.com/news/articles/2020-03-15/austria-c...

*Austria. Australia is 500.

Oh now they say it? What a lack of leadership.

You'd rather they not say it all?

I'd rather they said it a week or two ago.

So 49 people in a small room is okay? Like a classroom? WTF

Same CDC that refused the working tests from WHO, then made their own tests incorrectly, then produced so few tests that we have no idea who is infecting hundreds of others for days, weeks.

The post-analysis of this is going to be jaw-dropping. Like worse than "determined to fly airplanes into buildings" report that was ignored before 9/11

The purpose of these restrictions are to keep spread of the virus within communities and to avoid inter community infection. This helps significantly flatten the curve.

CDC says: >Remember, a COVID-19 outbreak could last for a long time.

It's already becoming more memorable for its poorly-controlled spread of damage, forseeable over an increasing period of time to come.

Q. Have a COVID-19 outbreak?

A. No, thanks, we already have one.

Reply on news.ycombinator.com